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Pre hospital care

John Dabis, Aliyah Hussein, Mark Rickman
Hip fractures represent a significant burden to the NHS: the cost for all UK hip fractures is approximately £2 billion and in 2013, 64 838 people were admitted to hospital with a fractured neck of femur (FNOF). In April 2010 St George's NHS Hospital was designated one of four Major Trauma Centres (MTC) in London. Following MTC designation, in April 2014 St George's Hospital opened a helipad. This study aimed to assess the impact of the helipad designation on the Trust's ability to meet the Best Practice Tariff (BPT) criteria for FNOF patients...
October 18, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Mulugeta Dile Worke, Lealem Meseret Bezabih, Mulat Adefris Woldetasdik
BACKGROUND: Contraception helps to prevent unplanned pregnancies among human immune virus positive women. The contraceptive utilization status and associated factors were not well addressed in the study area. Therefore, this study aimed to assess utilization of contraceptives and associated factors among human immune virus positive reproductive age group women appearing at anti-retroviral therapy clinic at the University of Gondar Hospital, North West Ethiopia. METHOD: An institution based cross-sectional study was conducted among 397 systematically selected HIV positive reproductive age women who visited ART unit of the University of Gondar teaching referral hospital from January 8-20, 2014...
October 21, 2016: BMC Women's Health
Jessica Quinlan-Woodward, Autumn Gode, Jeffery A Dusek, Adam S Reinstein, Jill R Johnson, Sue Sendelbach
PURPOSE/OBJECTIVES: To compare the effect of acupuncture to a standard-of-care (control) group on pain, nausea, anxiety, and ability to cope. 
. DESIGN: Pilot randomized, controlled trial. 
. SETTING: Abbott Northwestern Hospital, a large, urban, tertiary care hospital in Minneapolis, Minnesota.
. SAMPLE: 30 adult women undergoing surgery for breast cancer.
. METHODS: Women were randomly assigned to two hospital-based acupuncture treatments versus usual care after breast cancer surgery...
November 1, 2016: Oncology Nursing Forum
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Joyce Cheng, Paul Benassi, Claire De Oliveira, Juveria Zaheer, Michael Collins, Paul Kurdyak
OBJECTIVE: Despite the high prevalence of mental illnesses and addictions, treatment rates remain low. In April 2010, a regional mass media campaign was implemented to increase awareness of mental health services in central Toronto, Canada. We studied the impact of this campaign on rates of psychiatric emergency department (PED) visits among all hospital emergency departments (EDs) located in Toronto. DESIGN: Monthly PED visit totals were obtained for all Toronto EDs from April 1, 2007 to March 31, 2012 (n = 148,704)...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Sytske Anne Bergstra, Pedro M M C Machado, Rosaline van den Berg, Robert B M Landewé, Tom W J Huizinga
OBJECTIVES: Ten years ago, the METEOR tool was developed to simulate treatment-to-target and create an international research database. The development of the METEOR tool and database, research opportunities and future perspectives are described. METHODS: The METEOR tool is a free, online, internationally available tool in which daily practice visits of all rheumatoid arthritis patients visiting a rheumatologist can be registered. In the tool, disease characteristics, patient- and physician-reported outcomes and prescribed treatment could be entered...
September 2016: Clinical and Experimental Rheumatology
Maa-Ohui Quarmyne, Wei Dong, Rodney Theodore, Sonia Anand, Vaughn Barry, Olufolake Adisa, Iris D Buchanan, James Bost, Robert C Brown, Clinton H Joiner, Peter A Lane
The clinical efficacy of hydroxyurea in patients with sickle cell anemia (SCA) has been well established. However, data about its clinical effectiveness in practice is limited. We evaluated the clinical effectiveness of hydroxyurea in a large pediatric population using a retrospective cohort, pre-post treatment study design to control for disease severity selection bias. The cohort included children with SCA (SS, Sβ(0) thalassemia) who received care at Children's Healthcare of Atlanta (CHOA) and who initiated hydroxyurea in 2009-2011...
October 19, 2016: American Journal of Hematology
André Bohomol Velhote, Elena Bohomol, Manoel Carlos Prieto Velhote
Objective: To identify pediatric caregivers' reactions in outpatient surgery settings. Methods: A quantitative descriptive/exploratory survey-based study involving application of a semi-structured questionnaire to 62 caregivers in two hospitals. Results: Most caregivers (88.7%) were mothers who submitted to preoperative fasting with their children. Nervousness, anxiety and concern were the most common feelings reported by caregivers on the day of the surgery...
July 2016: Einstein
Marina Parca Cavelagna Teixeira, Tatiana Peloso Reis Queiroga, Maria Dos Anjos Mesquita
Objective: To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. Methods: This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio...
July 2016: Einstein
Beth Wieczorek, Judith Ascenzi, Yun Kim, Hallie Lenker, Caroline Potter, Nehal J Shata, Lauren Mitchell, Catherine Haut, Ivor Berkowitz, Frank Pidcock, Jeannine Hoch, Connie Malamed, Tamara Kravitz, Sapna R Kudchadkar
OBJECTIVE: To determine the safety and feasibility of an early mobilization program in a PICU. DESIGN: Observational, pre-post design. SETTING: PICU in a tertiary academic hospital in the United States. PATIENTS: Critically ill pediatric patients admitted to the PICU. INTERVENTION: This quality improvement project involved a usual-care baseline phase, followed by a quality improvement phase that implemented a multicomponent, interdisciplinary, and tiered activity plan to promote early mobilization of critically ill children...
October 10, 2016: Pediatric Critical Care Medicine
Mari-Lynn Drainoni, Elisa A Koppelman, James A Feldman, Alexander Y Walley, Patricia M Mitchell, Jacqueline Ellison, Edward Bernstein
BACKGROUND: The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose...
October 18, 2016: BMC Research Notes
Sarah Mahoney, Ruth M Sladek, Tim Neild
BACKGROUND: Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning. METHODS: There were three groups of participants: medical students (n = 281), who completed a longitudinal survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the beginning and end of the 2013 academic year; private doctors (medical practitioners) in South Australia (n = 78) who completed a survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the end of the students' academic year; and doctors (medical practitioners) from public teaching hospitals (n = 72) in southern Adelaide, South Australia who completed a survey consisting of the Jefferson Scale of Empathy at the end of the students' academic year ...
October 18, 2016: BMC Medical Education
Nicola Mackintosh, Marius Terblanche, Ritesh Maharaj, Andreas Xyrichis, Karen Franklin, Jamie Keddie, Emily Larkins, Anna Maslen, James Skinner, Samuel Newman, Joana Hiew De Sousa Magalhaes, Jane Sandall
BACKGROUND: Telemedicine applications aim to address variance in clinical outcomes and increase access to specialist expertise. Despite widespread implementation, there is little robust evidence about cost-effectiveness, clinical benefits, and impact on quality and safety of critical care telemedicine. The primary objective was to determine the impact of critical care telemedicine (with clinical decision support available 24/7) on intensive care unit (ICU) and hospital mortality and length of stay in adults and children...
October 18, 2016: Systematic Reviews
J E McDonagh, K L Shaw, J Prescott, F J Smith, R Roberts, N J Gray
BACKGROUND: Taking medicines as intended is difficult for everybody, but young people going through adolescence have greater problems than adults and younger children. One of the most important things that happen during the teenage years is the development of individual identities, which might not remain constant during this time and can be affected deeply by the diagnosis of a long-term condition. The aim of this study was to examine the relationships between identity and medication use among young people with juvenile arthritis...
October 19, 2016: Pediatric Rheumatology Online Journal
Lei Cheng, Yuxia Zhang, Ying Gu, Chunmei Lu, Qing Liu, Hao Yuan
BACKGROUND: Supporting and involving the families of pre-term infants' in the discharge process provides them with confidence in caring for their infants at home. In an effort to facilitate families' readiness for discharge, the neonatal unit (NU) of the Children's Hospital of Fudan University has implemented a best practice project. OBJECTIVES: The aim of this project was to integrate the best available evidence on facilitating families' readiness for discharge into the nursing practice of the Children's Hospital of Fudan University...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Cedric Mabire, Andrew Dwyer, Antoine Garnier, Joanie Pellet
BACKGROUND: Inadequate discharge planning for the growing elderly population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing's role or the specific components of these interventions. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be proven in practice. OBJECTIVES: To determine the best available evidence on the effectiveness of discharge planning interventions involving at least one nurse on health-related outcomes for elderly inpatients discharged home and to assess the relative impact of individual components of discharge planning interventions...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Hyun Ju Yoon
OBJECTIVE: The aim of this study was to investigate the impact of diastolic functional recovery on pre-discharge echocardiography on future adverse events in the patients with hypertensive heart failure (HHF). DESIGN AND METHOD: A total of 136 hospitalized patients with HHF were divided into 2 groups according to the change of diastolic function on pre-discharge echocardiography; the improving group (n = 65, 47.9 ± 14.4years, 49 males) vs non-improving group (n = 71, 52...
September 2016: Journal of Hypertension
Mohamed Kauser, Vagesh Sr, Kumaraswamy Rc, Asfia Afreen
OBJECTIVE: Hypertension is a chronic asymptomatic disease, often goes unnoticed for decades before it presents to the medical fraternity with devastating consequences. Low patient adherence is amenable for modification for better control of hypertension, if factors contributing to it are understood. Study was undertaken with the aims of assessing the factors responsible and their relative contributions toward nonadherence among hypertensives. DESIGN AND METHOD: We conducted a prospective observational study from August 2013 to August 2014...
September 2016: Journal of Hypertension
A M Acosta, M A D S Lima, G Q Marques, P F Levandovski, L A F Weber
AIM: To translate, adapt and evaluate psychometric properties of the complete (15 items) and reduced (three items) versions of the Care Transitions Measure into Brazilian Portuguese. INTRODUCTION: The Care Transitions Measure assesses the quality of care transitions, from the perspective of patients. As accomplishing effective transitions is a challenge to healthcare systems, the instrument provides an opportunity to assess care transitions and improve quality initiatives...
October 18, 2016: International Nursing Review
Amira Mustafa, Samar Mahgoub
Delays in the discharge of hospital patients cause a backlog for new admissions from the Emergency Departments (ED), outpatient clinics, and transfers from the Intensive Care Units (ICU). A variety of initiatives have been reported on previously which aim to tackle this problem with variable success. In this quality improvement project, we aimed to increase the proportion of discharged patients who leave the paediatric unit by 12:00 Noon from 7% to 30% by May 2015. A baseline discharge process map was studied to understand the possible causes of the delays...
2016: BMJ Quality Improvement Reports
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